What is the significance of hematuria (presence of blood in urine) and proteinuria (presence of excess proteins in urine) in a male patient?

From the Guidelines

If your urine analysis shows blood and proteins, you should seek immediate medical attention, as this combination of findings can indicate several serious conditions that require further investigation. The presence of hematuria (blood in urine) and proteinuria (excess proteins in urine) in a male patient can be signs of conditions such as urinary tract infections, kidney disease, or in older men, prostate issues 1. According to the American Urological Association (AUA) and the Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction (SUFU) guideline, patients with microhematuria should undergo risk-based urologic evaluation, and those with suspected medical renal disease should be referred to a nephrologist 1.

Key Considerations

• The combination of blood and protein in urine is considered abnormal and potentially serious, which is why prompt medical evaluation is necessary to identify and address the underlying cause.
• Patients with proteinuria, dysmorphic RBCs, cellular casts, or renal insufficiency may have medical renal disease, which can cause hematuria, and should be referred to a nephrologist 1.
• The National Kidney Foundation recommends assessing proteinuria to detect chronic kidney disease, and the ratio of protein or albumin to creatinine in an untimed urine specimen is the preferred method for measuring proteinuria 1.

Recommendations

• Contact your healthcare provider or go to an urgent care facility as soon as possible if you have hematuria and proteinuria.
• Increase your fluid intake to help flush out your urinary system, unless otherwise instructed by a doctor.
• Monitor for any additional symptoms such as pain while urinating, lower back pain, fever, or changes in urine color or frequency, which can provide valuable information to your healthcare provider.
• Only a healthcare professional can accurately determine the cause and appropriate treatment after a thorough examination and additional tests.

From the Research

Significance of Hematuria and Proteinuria

• Hematuria (presence of blood in urine) and proteinuria (presence of excess proteins in urine) are significant indicators of underlying kidney disease or other health issues in a male patient 2, 3, 4.
• Proteinuria is a well-known risk factor for the progression of renal disease and cardiovascular morbidity and mortality, and its presence can indicate kidney damage or disease 2.
• The presence of blood in urine can be a sign of various conditions, including urinary tract infections, kidney stones, or more serious diseases such as cancer 4.

Proteinuria and Kidney Disease

• Proteinuria is associated with a faster decline in renal function and an increased risk of cardiovascular events, making it a critical indicator of kidney health 2.
• The level of proteinuria can be used to monitor the progression of kidney disease and the effectiveness of treatment 2, 3.
• Certain proteins in the urine, such as those regulated by angiotensin II, can serve as biomarkers for kidney disease and may be useful in monitoring disease progression or response to treatment 3.

Urinary Proteome and Biomarker Discovery

• The urinary proteome is a complex and dynamic system that can reflect changes in the body and provide valuable information for biomarker discovery 5, 4, 6.
• Various factors, including diuretics, can affect the urinary proteome and must be carefully evaluated in biomarker studies 6.
• The analysis of urinary proteins can provide insights into kidney function and disease, as well as other health conditions, and may lead to the development of new biomarkers and diagnostic tools 5, 3, 4.